Menstruation - absent

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Absence of menstruation (amenorrhea)

Menstruation - absent

Alternative Names:

Missed periods; Lack of menses; Periods - missed; Amenorrhea
Home Care:

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Treatment depends on the cause:

For amenorrhea caused by normal delay of menstruation onset, have patience until age 16.
For a missed period that may be caused by pregnancy, consult your obstetrician to confirm pregnancy.
For a missed period caused by drastic weight loss or obesity, proper diet is recommended.
For a missed period resulting from excessive exercise, use moderation and cut back to a more conservative program.

Call your health care provider if:

There is no satisfactory explanation for a missed period.

What to expect at your health care provider's office:

The medical history will be obtained and a physical examination performed.

A complete health history will be obtained, including a menstrual history. Questions may include the following:

Menstrual history
- Are you a woman presently in a menstruating age range (over 12 and under 55)?
- Are you sexually active?
- Do you use birth control? What type?
Quality
- Was the previous menstrual period a normal amount?
- Are the menses absent or decreased?
- Do you usually have regular periods?
Time pattern
- When was your last menstrual period?
- At what age did you have your first menstrual period?
- Have you ever had normal periods?
Aggravating factors
- What medications do you take?
- How much do you exercise?
Other symptoms
- What other symptoms are also present?
- Is there breast tenderness?
- Is there morning nausea and vomiting?
- Is there a headache?
- Is there a nipple discharge (and not breast feeding)?
- Is there vision loss or change in vision?
- Is there an unintentional weight gain?
- Is there an unintentional weight loss?
- Is there vaginal dryness?
- Is there hair growth in a male pattern?
- Are there voice changes?
- Are there changes in the breast size?
- Is there excessive anxiety?

A physical examination, including a pelvic examination, will be performed. In patients with secondary amenorrhea, physical and pelvic examinations must rule out pregnancy before diagnostic testing begins. The patient may be encouraged to discuss her fears and, if indicated, may be referred for psychological counseling.

Diagnostic tests that may be performed include: